There are two major challenges that Long-Term Care (LTC) Nurses face, and they stem from the rise in acuity of patients and associated staffing issues.

Higher Acuity

Higher acuity simply means more complex. Patients are living longer and longer with more chronic conditions and requiring more care. This is true across all healthcare settings. The implications this has for a long-term care nurse is that they are tasked with more complex and challenging medical patients in a setting that is not acute. While it presents challenges, it is a great opportunity for nurses to practice and advance their nursing skills. Nurses may be assigned to patients that, for example, have complex wound dressings that are time-consuming, thus developing nursing skills as well as time management.


Piggybacking on the higher acuity challenges, LTC facilities may have only one or two doctors (depending on the size of the facility) that are responsible for the care of patients. There are teams of clinical staff including nurses, a social worker, case manager, nursing assistants, med techs and other staff to assist with patients. However, due to the complexity of some patients, the time it takes to complete patient care is higher and thus spreads staffing thin. LTC facilities with staffing issues struggle when staff need to take vacations or call out ill, which can contribute to lower job satisfaction and a higher turnover rate.

Both of these challenges can be improved. Staffing changes to account for acuity of patients has been practiced and implemented in many facilities. The previous model was based on numbers rather than acuity. These updated have improved patient and employee satisfaction, ensuring the nurses have adequate support and time to provide the best care to their patients.

Amanda Bucceri Androus, RN, BSN
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